Abner O Rayapati MD LLC
Organization Active NPI Psychiatry Physician · Lexington, KY
NPI 1437879541 · NPPES record last updated Aug 30, 2022
Key facts
- NPI
- 1437879541
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Psychiatry Physician 2084P0800X
- Legal business name
- ABNER O RAYAPATI MD LLC
- Practice address
- 2220 Executive Dr Ste 102
Lexington, KY 40505-4871 - Phone
- (859) 737-0904
- NPI assigned
- Aug 30, 2022
- Organization subpart
- No
Authorized official
- Name
- David Carter
- Title
- Credentialing Manager
- Phone
- (859) 737-0904
Practitioners 2
-
Andrea L Baker, LCSW
-
Abner Oliver Rayapati, M.D., MPH
Laboratory certificates & supplier records
CLIA laboratory certificates
| CLIA number | Laboratory | Certificate | Expires |
|---|---|---|---|
| 18D2331168 | Abner O Rayapati MD, LLC | Certificate of waiver | Sep 25, 2027 |
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in KY
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20231010002077 | KY | Part B Supplier - Clinic/Group Practice | 4688033418 |
Receives reassigned benefits from 2 practitioners Practice locations: Lexington, KY |
National Provider Directory
Locations
2220 Executive Dr
Ste 102
Lexington, KY 40505
Phone (859) 309-2603
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Psychiatry Physician |
2084P0800X | Yes |
Addresses
Primary practice location
2220 Executive Dr Ste 102
Lexington, KY 40505-4871
Mailing address
2220 Executive Dr Ste 102
Lexington, KY 40505-4871
Electronic endpoints
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| Direct Messaging Address | david@mpcg.org |
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Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Aug 30, 2022. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.